Jonathan Samet, MD, paints a smoky image of his early profession in medication when smoking was the norm and was even allowed in hospitals. 

“The so-called nursing station was smoke-filled, some specialties made rounds with cigarettes in their hands, and instructors smoked in class,” mentioned Samet. “The world was completely different.”

Samet, founding director of the Institute for Global Tobacco Control, shared these experiences in a Public Health On Call episode, the place he and Joanna Cohen, PhD, MHSc, present IGTC director and Bloomberg Professor of Disease Prevention within the Department of Health, Behavior and Society, mentioned the previous, current, and future within the battle in opposition to tobacco. 

When Samet first got here to the Bloomberg School in 1994 to be chair of the Department of Epidemiology, Johns Hopkins “didn’t have a focal point for work on tobacco,” he mentioned.

While the U.S. was beginning to see some progress and adjustments in coverage in these years, the tobacco business strategically turned its advertising and marketing efforts to different nations that may not have had the flexibility to implement sturdy insurance policies in opposition to tobacco. 

“Clearly there was a need for working with colleagues in other countries, moving some of the lessons learned in the U.S. and other higher-income countries to places that faced the peril of the rising use of tobacco with the aggressive and well-honed tactics of the industry,” mentioned Samet. 

Samet’s early work with nations like China spearheaded IGTC’s founding. In 25 years since, the Institute has turn into a worldwide chief within the efforts to finish the tobacco epidemic.
Today, tobacco smoking charges, particularly amongst children, are declining within the U.S., however the battle in opposition to tobacco forges on as new merchandise like e-cigarettes enter the tobacco market.

“There’s always an ongoing need, unfortunately, in tobacco control … to counter the ever-shifting strategies of this very chameleon-like industry,” mentioned Cohen. 

Under Cohen’s course, the IGTC is specializing in world surveillance work to affect tobacco management insurance policies.

For instance, IGTC has surveyed tobacco advertising and marketing on the level of sale (the bodily location the place individuals can purchase tobacco merchandise). Cigarettes and different tobacco merchandise are usually not solely seen by individuals who buy them, however each different buyer “sees all the advertising and the beautiful products displayed,” mentioned Cohen. Another study spanning 42 completely different nations demonstrates how these merchandise explicitly goal kids by inserting tobacco merchandise at eye stage for them to see—and are even marketed and promoted in shops close to faculties and playgrounds.

With a majority of these research and surveillance, Cohen hopes to equip policymakers and public well being professionals with proof to assist them say, “We have to do something about this,” and enact insurance policies that can change how cigarettes are designed and the place they’re positioned in shops.

Many nations, together with some low- and middle-income nations, have made main strides in decreasing smoking charges. Cohen held in her hand a cigarette pack from Australia, one of many first nations to implement graphic well being warning labels on cigarette packs. The label exhibits an unsettling picture of smoking’s results and is supposed to impress an emotional response. This specific bundle confirmed a protruding eye with the phrases “Smoking causes blindness.”

In this regard, the U.S. has some catching as much as do. 

“We’ve been promised since 2009 with the Tobacco Act that there will be picture warnings. We’re still waiting,” mentioned Cohen.

In different nations, efforts to scale back smoking embody banning tobacco shows and placing tobacco merchandise beneath the counter or behind closed cabinets, out of consumers’ view.

Samet factors to Beijing as a trailblazer for implementing strict non-smoking ordinances. The metropolis is now 100% smoke-free, however smoking stays pervasive in different components of the nation. China’s authorities makes and sells cigarettes, primarily by means of its state monopoly, China National Tobacco, and generates substantial revenues from tobacco.

The way forward for tobacco management seems to be to be extra complicated with tobaccoless, nicotine-filled, fun-flavored e-cigarettes concentrating on children.

“We’ve seen a whole epidemic of youth starting to use these products, getting addicted to nicotine, who would not have used nicotine without these,” mentioned Cohen.

Cohen want to see the FDA regulate these merchandise for use for good, like serving to individuals give up smoking tobacco. 

Despite shifting tendencies in merchandise, Cohen stays optimistic and has her eyes on the tobacco endgame.

“I’m really excited about the energy that’s being brought to bringing an end to the tobacco epidemic once and for all.”

Grace Fernandez is a communications affiliate within the Office of External Affairs on the Johns Hopkins Bloomberg School of Public Health and assistant producer of Public Health On Call.

RELATED: